Mal Presentations

Common causes of malpresentations/malpositions include:

• Excess amniotic fluid
• Abnormal shape and size of the pelvis
• Uterine tumor
• Placenta praevia
• Slackness of uterine muscles (after many previous pregnancies)
• Multiple pregnancy.

• Prematurity
• Multiple pregnancy
• Abnormalities of the uterus - fibroids.
• Partial septate uterus.
• Abnormal fetus.
• Placenta praevia.
• Primiparity

On abdominal examination, the head is felt in the upper abdomen and the breech in the pelvic brim. Auscultation locates the fetal heart higher than expected with a vertex presentation. On vaginal examination during labour, the buttocks and/or feet becomes thick, dark meconium is normal.

It may be possible to correct the malpresentation by gently turning the baby into a head-first position. This is done by an obstetrician using a technique called external cephalic version (ECV).